Surgical kit for the preparation of tamponade gas

ABSTRACT

A surgical kit to prepare a unit dose injection of a surgical gas. The surgical kit includes a gas pouch filled with a surgical gas, a syringe with a needle and a plunger. Optionally additional product components are included in the surgical kit depending on the surgical procedure for which the kit is prepared, such as for example a sterilizing filter, a stopcock and a suspended spike. Preferably the surgical kit may be used in ophthalmic surgical procedures to prepare a unit dose of tamponade gas to repair retinal tears.

FIELD OF THE INVENTION

[0001] The present invention relates generally to a surgical kit for thepreparation of a surgical gas and a method of assembling and using thesame. More specifically, the present invention relates to a surgical kitand the assembly and use thereof to provide a unit dose of tamponade gasto a patient during an ophthalmic surgical procedure.

BACKGROUND OF THE INVENTION

[0002] Syringes filled with a gas are useful in a number of surgicalprocedures requiring the injection of a gas bubble into a patient'sbody. One such surgical procedure requiring the injection of a gasbubble into a patient is that of repairing a retinal tear. A retinaltear can be treated using an injected gas bubble such as sulfurhexafluoride (SF6), perfluoroethane (C2F6) or perfluoropropane (C3F8)for gas tamponage. Another such surgical procedure is that of injectingcarbon dioxide (CO2) gas into a blood vessel to facilitate percutaneousangioscopy. Still another such surgical procedure is that of usinginjections of nitric oxide (NO) gas and NO-releasing compounds to treatmale impotence, inhibition of DNA synthesis and mitochondrialrespiration in tumor cells, and to relax vascular smooth muscle forcontrol of hypertension.

[0003] Gases used for such surgical procedures are often expensive andnot available in ready-to-use unit dose form. Currently, surgical gasesare purchased packaged in pressurized tanks. Syringes are filleddirectly from the tanks using a filling line. When a syringe isdisconnected from the filling line, the gas remaining in the fillingline is released into the atmosphere. Thus, this method of preparingsyringes for surgery is not entirely desirable due to the significantamount of gas that is wasted. Additionally, due to the busy environmentof a hospital, shut-off valves on surgical gas tanks are frequently leftopen accidentally causing an even greater amount of gas to be wastedthan when syringes are being filled.

[0004] An even more serious problem than that of wasting expensivesurgical gases, is that of gas dilution within the prepared syringeprior to surgery. Syringes are sometimes prepared on the morning of theday they are to be used in a surgical procedure. Once prepared, thesyringes are placed in the operating room with other surgical devicesuntil they are used, which can be several hours later. Experiments haveshown that leakage of surgical gas from a syringe over a relativelyshort period of time can cause clinically significant dilution of thegas thereby increasing the risk of surgical complications. For instance,the concentration of sulfur hexafluoride in a plastic syringe has beenobserved to decrease from 97% at 30 seconds after aspiration to 76% at60 minutes and 2% at 18 hours after aspiration.

[0005] In U.S. Pat. No. 6,073,759 a method of preparing a gas-filledsyringe is disclosed which comprises filling a high gas barrier materialcontainer with a predetermined volume of a gas, puncturing the containerwith the syringe needle and drawing the gas into the syringe byretracting the syringe plunger. As taught, such a method is not entirelydesirable due to complications associated with the need to maintain thegas-filled container at a pressure above atmospheric pressure.

[0006] In U.S. Pat. No. 5,390,792 packaging for protective sterilecontainment of a rigid product is disclosed. The packaging is designedto enable circulation of sterilizing fluids about the surface of therigid product for improved and substantially unhindered circulation ofsterilizing gases throughout the interior of the packaging. Suchpackaging is desirable for purposes of sterilization but is not suitablefor packaging of surgical gases due to the characteristics of thebreathable plastic cover film.

[0007] In U.S. Pat. No. 5,377,835 a reclosable film package is disclosedwhich is light-tight, air-tight and reclosable made from metallizedpolyester foil, lined with black polyethylene. A reclosable film packageis not desirable in conjunction with the packaging of surgical gases dueto the preference for single-use only products.

[0008] Because of the noted shortcomings of current packaging designs,there is a need for a surgical kit designed for the preparation and useof a unit dose of surgical gas.

SUMMARY OF THE INVENTION

[0009] The present invention provides a surgical kit for the preparationof a unit dose of a surgical gas, such as a tamponade gas for ophthalmicuse, and a method of using the same. The product components of thesubject kit are preferably provided in a sterile blister-type packagingstructure formed from a rigid resiliently flexible thermoformed plasticcontainer and a sealed cover therefor. The plastic container preferablyhas a plurality of indentations molded or thermoformed therein. Theindentations form interior contacting surfaces shaped in correlationwith the exterior surface dimensions of the product components housed inthe container so as to position the product components therein in aspecified orientation. The interior contacting surfaces likewiseprotectively maintain product components within the packaging structurein a fixed position during shipping and handling of the surgical kit soas to secure the same from potential damage due to impacts and/or shocksimparted during shipping and/or storage.

[0010] The preferred surgical kit of the present invention includes agas pouch filled to approximately atmospheric pressure, such as withinthe range of approximately 0.95 to 1.05 atmospheres of pressure with asurgical gas, a syringe with plunger, a sterilizing filter, a stopcock,a suspended spike and a capped injection needle or cannula as productcomponents. However, numerous product component variations may beincluded in the subject surgical kit, depending on the surgicalprocedure for which the kit is prepared, to provide for the preparationof a unit-dosage of gas for use in surgery.

[0011] The gas-filled syringe is prepared just before surgery byconnecting the sterilizing filter, the stopcock and the suspended spikerespectively to the syringe. The suspended spike is then used toperforate a plug positioned within a filling nozzle of the gas pouch.The desired volume of surgical gas is drawn into the syringe bywithdrawing the plunger a specific distance from within the syringeinterior as dictated by the volume desired. The stopcock is then closedto seal the gas pouch prior to removal of the syringe. A cappedinjection needle or cannula is then connected to the syringe for use ina surgical procedure. Alternatively, a syringe with a capped injectionneedle or cannula can be directly used to perforate the plug positionedwithin the filling nozzle of the gas pouch depending on the requirementsof the specific surgical procedure.

[0012] If a gas/air mixture is desired for the surgical procedure, thesyringe and the sterilizing filter are removed from the stopcock. Toprepare a gas/air mixture, if desired, the desired volume of air isdrawn into the syringe through the sterilizing filter by withdrawing theplunger a specific distance from within the syringe interior as dictatedby the volume desired. The sterilizing filter is then removed from thesyringe and the capped injection needle or cannula connected to thesyringe for use in a surgical procedure.

[0013] Accordingly, it is an object of the present invention to providea surgical kit for the preparation of a surgical gas.

[0014] Another object of the present invention is to provide a surgicalkit for the preparation of a unit-dose of tamponade gas.

[0015] Another object of the present invention is to provide a surgicalkit for the preparation of a unit-dose gas/air mixture.

[0016] Another object of the present invention is to provide a method ofusing product components of a surgical kit for the preparation of atamponade gas.

[0017] Still another object of the present invention is to provide amethod of using product components of a surgical kit for the preparationof a unit-dose gas/air mixture.

[0018] These and other objectives and advantages of the presentinvention, some of which are specifically described and others that arenot, will become apparent from the drawings, detailed description andclaims that follow.

BRIEF DESCRIPTION OF THE DRAWINGS

[0019]FIG. 1 is a plan view of a surgical kit made in accordance withthe present invention;

[0020]FIG. 2 is a plan view of the gas pouch product component of thesurgical kit of FIG. 1;

[0021]FIG. 3 is a plan view of the syringe product component of thesurgical kit of FIG. 1;

[0022]FIG. 4 is a plan view of the sterilizing filter product componentof the surgical kit of FIG. 1;

[0023]FIG. 5 is a plan view of the stopcock product component of thesurgical kit of FIG. 1;

[0024]FIG. 6 is a plan view of the suspended spike product component ofthe surgical kit of FIG. 1;

[0025]FIG. 7 is a plan view of the capped injection needle productcomponent of the surgical kit of FIG. 1;

[0026]FIG. 8 is a plan view of the assembled syringe, sterilizingfilter, stopcock and suspended spike product components of the surgicalkit of FIG. 1;

[0027]FIG. 9 is a plan view of the assembled syringe, sterilizingfilter, stopcock, suspended spike and gas pouch product components ofthe surgical kit of FIG. 1;

[0028]FIG. 10 is a plan view of the assembled gas pouch, suspended spikeand stopcock product components of the surgical kit of FIG. 1; and

[0029]FIG. 11 is a plan view of the assembled syringe and cappedinjection needle product components of the surgical kit of FIG. 1.

DETAILED DESCRIPTION OF THE INVENTION:

[0030] The present surgical kit 10 is best illustrated in FIG. 1.Surgical kit 10 is preferably provided for the preparation of a unitdose ophthalmic tamponade gas injection. However, surgical kit 10 islikewise suitable for use in the preparation of other surgical gases 28for use in other surgical procedures. Product components 12 of surgicalkit 10 are preferably provided in a sterile blister-type packagingstructure 14 formed from a rigid resiliently flexible thermoformedplastic container 16 and a non-permanently sealed cover 18 therefor.Packaging structure 14 is preferably suitably sized for convenience inuse and storage. For this purpose, packaging structure 14 is ideallysmaller than 20 inches by 20 inches and more preferably smaller than 12inches by 12 inches although larger sizes could be used to accommodatethe needs of a particular surgical procedure. Suitable materials for themanufacture of plastic container 16 include but are not limited topolypropylene, polyethylene terephthalate copolyester or polyvinylchloride. Preferably plastic container 16 is manufactured frompolyethylene terephthalate copolyester for purposes of environmentalfriendliness. Suitable materials for the manufacture of sealed cover 18include but are not limited to a spun bonded olefin material such asTyvek™ (Dupont, Wilmington, Del.), polypropylene, polyethyleneterephthalate copolyester, polyvinyl chloride or coated paper such asPGL 70 or PGL 110. Preferably, sealed cover 18 is manufactured fromcoated paper for increased ease with respect to sterilization methods.Plastic container 16 is preferably molded or thermoformed to have aplurality of indentations 20 formed therein. Indentations 20 forminterior contacting surfaces 22 shaped in correlation with the exteriorsurface dimensions 24 of product components 12 housed in plasticcontainer 16 so as to position product components 12 therein in aspecified orientation. The interior contacting surfaces 22 likewiseprotectively maintain product components 12 within the packagingstructure 14 in a fixed position during shipping and handling ofsurgical kit 10 so as to secure the same from potential damage due toimpacts and/or shocks imparted during shipping and/or storage. Sealedcover 18 may be planar or alternatively molded or thermoformed to haveindentations 20 formed therein to correspond with those of plasticcontainer 16. Plastic container 16 and sealed cover 18 are manufacturedto be capable of being non-permanently sealed through the use of asuitable adhesive or by heat-sealing for the purpose of maintaining thesterility of product components 12 contained therein.

[0031] Product components 12 of surgical kit 10, as best illustrated inFIGS. 2 through 7, preferably include a gas pouch 26 filled toapproximately atmospheric pressure such as within the range ofapproximately 0.95 to 1.05 atmospheres of pressure with a surgical gas28, a syringe 30 with a plunger 34, a sterilizing filter 44, a stopcock56, a suspended spike 68 and a capped injection needle 76. Optionally, acannula could also be used in the present invention rather than cappedinjection needle 76. However, for purposes of simplicity, the presentinvention will be described in terms of using only a capped injectionneedle 76. Surgical kit 10 could likewise be customized such as byadding to product components 12, deleting from product components 12 ormodifying product components 12 as desired to accommodate therequirements of particular surgical procedures during which a surgicalgas 28 is used.

[0032] The subject surgical kit 10 provides for the preparation of aunit-dosage of surgical gas 28 for use in a surgical procedure. Thepreferred surgical gas is provided in gas pouch 26. Gas pouch 26illustrated in FIG. 2 is manufactured from a gas barrier material suchas metal foils or metallized polymer laminates such as laminates havingone or more metallized layers of nylon, oriented polypropylene,polyethylene, ethylene vinyl alcohol, polyethylene terephthalate, lowdensity polyethylene, medium density polyethylene or cellophane. Alacquer or like coating can also be used to create a cold seal.Preferably, the present gas pouch 26 is manufactured from a laminarsheet of three materials of differing characteristics. The firstmaterial layer 88 forming the exterior 25 of gas pouch 26 is a24-micrometer thick layer of polyester to provide the necessarymechanical strength to gas pouch 26. The second material layer 90 isadhered to first material layer 88 using a polyurethane bi-componentadhesive. Second material layer 90 is a 12-micrometer thick layer ofaluminum to provide a gas barrier and a light barrier. The thirdmaterial layer 92 forming the interior 27 of gas pouch 26 is a70-micrometer thick layer of polyethylene to provide the necessaryability to weld the materials together to form a permanently sealedpouch for containment of surgical gas 28. Sealed between interior 27 ofanterior surface 98 and interior 27 of posterior surface 100 is a sealedend 102 of a filling nozzle 94. Filling nozzle 94 is preferably oftubular construction having an open passageway 106 in fluidcommunication with interior 27 of gas pouch 26 extending from sealed end102 to free end 104. Located between sealed end 102 and free end 104 isvalve portion 96. Valve portion 96 is constructed to have passageway 106of a diameter greater than that of sealed end 102 and free end 104.Fixed within enlarged passageway 106 of valve portion 96 is a natural orsynthetic rubber or rubber-like material gas barrier plug 108.Passageway 106 of free end 104 is dimensioned to accept a tubular spike74 for perforation of gas barrier plug 108 as described in greaterdetail below. Surgical gases 28 that may be packaged in gas pouch 26include but are not limited to sulfur hexafluoride, perfluoropropane,perfluoroethane, carbon dioxide, nitric oxide or nitric oxide releasingcompounds but preferably sulfur hexafluoride, perfluoropropane orperfluoroethane for use a tamponade in ophthalmic surgical procedures.Gas pouch 26 is filled to approximately atmospheric pressure, such aswithin the range of approximately 0.95 to 1.05 atmospheres of pressure,with surgical gas 28 by using a form/fill/seal machine or by evacuation,filling with a selected gas and sealing. Gas pouch 26 is preferablyfilled to approximately atmospheric pressure to avoid condensationwithin gas pouch 26 and concomitant contamination. The volume of gaspouch 26 may vary depending on the requirements of the particularsurgical procedure for which surgical kit 10 is tailored. Preferably,for purposes of providing tamponade gas for use in ophthalmic surgery torepair a retinal tear, the volume of gas pouch 26 is approximately 30 to100 cubic centimeters and most preferably 50 to 60 cubic centimeters.

[0033] Another product component 12 included in surgical kit 10 is asyringe 30. Syringe 30 as illustrated in FIG. 3 has a body portion 32having a longitudinally cylindrical section 110, a frustoconical section112 and a gas delivery outlet 114 with a gas dispensing tip 38 and alocking means 36, which are all preferably formed as an integral,unitary member. Body portion 32 can be formed from a material with ahigh degree of gas impermeability such as glass or one or more suitablepolymers such as but not limited to polypropylene. Interior 31 of bodyportion 32 defines a passageway 116, which can be filled with one ormore selected gases in a conventional manner. One or more gases may beretained within passageway 116 by plunger 34 and capped injection needle76. Interior end 118 of plunger 34 proximal with respect to thefrustoconical section 112 of body portion 32 can be provided with astopper 120 dimensioned to slidably engage interior 31 of body portion32 to controllably change the level of gas pressurization withinpassageway 116. Gas dispensing tip 38 is dimensioned for removableattachment of a sterilizing filter 44 or a capped injection needle 76.Formed around base periphery 122 of gas dispensing tip 38 are lockingmeans 36 for removable attachment of sterilizing filter 44 or cappedinjection needle 76. Locking means 36 may take any of a variety of formsknown to those skilled in the art such as but not limited to threads,one or more spaced tabs or one or more spaced grooves but preferablythreads. Preferably volume indicia 42 is likewise provided on bodyportion 32 for ease in using syringe 30 to provide a unit dose ofsurgical gas 28.

[0034] Another product component 12 included in surgical kit 10, whichmay be optional depending on surgical procedure, is sterilizing filter44 as illustrated in FIG. 4. Sterilizing filter 44 is formed from anysuitable material including but not limited to polypropylene orpolyvinyl chloride but preferably polyvinyl chloride. Sterilizing filter44 preferably comprises two permanently connected housing members 124and 126 with two opposed tubular extensions 50 and 52 respectivelyextending therefrom. Protruding from the exterior surface 132 of tubularextension 50 is one or more flange locking means 54. Flange lockingmeans 54 are proportioned to be accepted by locking means 36 of syringe30 for non-permanent attachment thereto. Tubular extension 52 isproportioned to be accepted within passageway 60 of stopcock 56 andnon-permanently attached therein by friction fit. Connected housingmembers 124 and 126 form a cavity 46 in fluid communication withpassages 128 and 130 of tubular extensions 50 and 52 respectively.Within cavity 46 is a bacterial and microbial barrier material 48 suchas but not limited to polyvinylidene fluoride or polytetrafluoroethylenebut preferably polyvinylidene fluoride. Sterilizing filter 44 is used toensure sterility of any surgical gas 28 or gases drawn within syringe30.

[0035] Another product component 12 of surgical kit 10, which may beoptional depending on surgical procedure, is stopcock 56 as illustratedin FIG. 5. Stopcock 56 is formed from any suitable material such as butnot limited to polycarbonate/acetal or polycarbonate but preferablypolycarbonate. Stopcock 56 comprises a tubular member 58 having twoopposed free ends 136 and 138 and an interior 134 defining a passageway60 therethrough. Tubular member 58 has a valve member 64 equipped with avalve handle 66. Valve member 64 extends through tubular member 58between opposed free ends 136 and 138. Upon parallel alignment of valvehandle 66 with regard to tubular member 58, valve member 64 allows fluidflow through tubular member 58. Upon perpendicular alignment of valvehandle 66 with regard to tubular member 58, fluid flow through tubularmember 58 is blocked. Free end 136 is dimensioned for removable frictionfit attachment of a sterilizing filter 44. Formed around base periphery140 of free end 138 are locking means 62 for removable attachment of asuspended spike 68. Locking means 62 may take any of a variety of formsknown to those skilled in the art such as but not limited to threads,one or more spaced tabs or one or more spaced grooves but preferablythreads.

[0036] Another product component 12 of surgical kit 10, which may beoptional depending on surgical procedure, is a suspended spike 68 asillustrated in FIG. 6. Suspended spike 68 may be manufactured from anysuitable material such as but not limited to acrylonitrile butadienestyrene terpolymer or polyethylene but preferably acrylonitrilebutadiene styrene terpolymer. Suspended spike 68 comprises a tubularbody portion 80 having two opposed free ends 146 and 148, gripping means142 and flange portion 144. Preferably gripping means 142 are formed bya series of ridges to increase friction and aid handling. Other suitablemethods of increasing the friction of gripping means 142 include but arenot limited to a plurality of raised knobs or buttons or a coating ofnatural or synthetic rubber or rubber-like material. Flange portion 144is provided to allow a user to abut one's fingers there against to aidin forcing elongated tubular spike 74 through gas barrier plug 108 orthe like. Extending from free end 146 are tubular locking means 72,which may take any of a variety of forms known to those skilled in theart such as but not limited to threads, one or more spaced tabs or oneor more spaced grooves but preferably threads. Tubular locking means 72is dimensioned for non-permanent attachment to free end 138 of stopcock56. Extending from free end 148 of suspended spike 68 is elongatedtubular spike 74 having a sharpened tip 150. Passageway 152 is definedby interior surfaces 154 of tubular spike 74, tubular body portion 80and tubular locking means 72 for fluid communication therethrough.

[0037] Still another product component 12 of surgical kit 10 is cappedinjection needle 76 as illustrated in FIG. 7. Capped injection needle 76comprises a tubular body portion 80, a tubular needle 82 and a cap 84.Tubular body portion 80 has two opposed ends 156 and 158. Tubular needle82 is permanently attached to end 156. Interior 162 defines passageway164 that allows fluid communication through tubular needle 82 and bodyportion 80. Extending from end 158 are locking means 160, which may takeany of a variety of forms known to those skilled in the art such as butnot limited to a flange, threads, one or more spaced tabs or one or morespaced grooves but preferably a flange. Cap 84 is tubular having aclosed end 168 and an opposed open end 170. Interior 174 of cap 84defines a cavity 172 dimensioned to envelop tubular needle 82 andnon-permanently attach by friction fit of open end 170 to exteriorsurface 166 of body portion 80.

[0038] Product components 12 are sterile in non-permanently sealedpackaging structure 14 to facilitate the sterile transfer of productcomponents 12 from packaging structure 14 into a sterile environmentsuch as a surgical operating room. The interior of packaging structure14 and product components 12 non-permanently sealed therein may besterilized using one of a variety of methods known to those skilled inthe art such as but not limited to exposure to sterilizing gases,radiation or the like.

[0039] Surgical kit 10 is used in a surgical procedure by preparingsyringe 30. Syringe 30 is prepared by filling the same with surgical gas28 just before the surgical procedure by removing cover 18 fromcontainer 16, removing necessary product components 12 from container 16and connecting sterilizing filter 44, stopcock 56 and suspended spike 68respectively to syringe 30 as illustrated in FIG. 8. Suspended spike 68is then used to perforate gas barrier plug 108 as illustrated in FIG. 9.The desired volume of surgical gas 28 is drawn into syringe 30 bywithdrawing plunger 34 from interior 31 of body portion 32 as necessaryto achieve the desired volume. Stopcock 56 is then manipulated to blockfluid flow by rotating valve handle 66 ninety degrees so as to beperpendicular with respect to tubular portion 58. If a gas/air mixtureis desired, syringe 30 and non-permanently attached sterilizing filter44 are then removed from stopcock 56 as illustrated in FIG. 10. Thedesired volume of air is drawn into syringe 30 through sterilizingfilter 44 by withdrawing plunger 34 from interior 31 of body portion 32as necessary to achieve the desired volume. Sterilizing filter 44 isthen removed from prepared syringe 86 and capped injection needle 76 isconnected to prepared syringe 86 for use in a surgical procedure asillustrated in FIG. 11. If a gas/air mixture is not desired, syringe 30is removed from sterilizing filter 44 following filling with surgicalgas 28 and connected to capped injection needle 76 for use in a surgicalprocedure. Alternatively, depending on the requirements of the surgicalprocedure, syringe 30 with connected capped injection needle 76 may beused by removing cap 84 to perforate gas barrier plug 108 and directlyfill syringe 30 with surgical gas 28 as described above.

[0040] While there is shown and described herein certain specificembodiments of the present invention, it will be manifest to thoseskilled in the art that various modifications may be made withoutdeparting from the spirit and scope of the underlying inventive conceptand that the same is not limited to the particular forms herein shownand described except insofar as indicated by the scope of the appendedclaims.

We claim:
 1. A surgical kit for the preparation of a unit dose injectionof a surgical gas comprising: a syringe with a needle or cannula and aplunger; a gas pouch equipped with a gas barrier plug and filled toapproximately atmospheric pressure with a surgical gas; and anon-permanently sealable packaging structure sized for containment ofsaid syringe and said gas pouch therein.
 2. The surgical kit of claim 1including within said packaging structure a stopcock.
 3. The surgicalkit of claim 1 including within said packaging structure a sterilizingfilter.
 4. The surgical kit of claim 1 including within said packagingstructure a suspended spike.
 5. The surgical kit of claim 1 includingwithin said packaging structure a stopcock, a sterilizing filter and asuspended spike.
 6. The surgical kit of claim 1 wherein said gas pouchis filled to approximately atmospheric pressure with a surgical gas. 7.The surgical kit of claim 1 wherein said surgical gas is selected fromthe group consisting of sulfur hexafluoride, perfluoropropane,perfluoroethane, nitric oxide, and nitric oxide producing compounds. 8.The surgical kit of claim 1 wherein said surgical gas is sulfurhexafluoride, perfluoropropane or perfluoroethane for use as a tamponadein an ophthalmic surgical procedure.
 9. The surgical kit of claim 1wherein said surgical gas is sulfur hexafluoride, perfluoropropane orperfluoroethane for use as a tamponade in an ophthalmic surgicalprocedure to repair retinal tears.
 10. The surgical kit of claim 1wherein said gas pouch is manufactured from a laminar sheet formed fromthree materials of differing characteristics.
 11. The surgical kit ofclaim 1 wherein said gas pouch is manufactured from a laminar sheetcomprising a polyester layer, an aluminum layer and a polyethylenelayer.
 12. A method of using the surgical kit of claim 1 to prepare aunit dose of a surgical gas for a surgical procedure consisting of:removing a cover from said packaging structure; removing said syringeand gas pouch from within said packaging structure; and filling saidsyringe with said surgical gas from said gas pouch by puncturing a valveon said gas pouch with said syringe needle or cannula and withdrawingsaid plunger from said syringe as necessary to fill said syringe with aunit dose of said surgical gas.
 13. A method of using a surgical kit toprepare a unit dose of a surgical gas for a surgical procedureconsisting of: removing a cover from a packaging structure; removing asyringe with a plunger, a sterilizing filter, a stopcock and a suspendedspike from within said packaging structure; non-permanently attachingsaid sterilizing filter, stopcock and suspended spike respectively withsaid syringe; removing a gas pouch from said packaging structure;puncturing a valve on said gas pouch with said suspended spike;withdrawing said plunger from said syringe as necessary to fill saidsyringe with a unit dose of said surgical gas; disconnecting saidsyringe from said sterilizing filter; and capping said syringe with acapped injection needle or cannula.
 14. A method of using a surgical kitto prepare a unit dose of a surgical gas for a surgical procedureconsisting of: removing a cover from a packaging structure; removing asyringe with a plunger, a sterilizing filter, a stopcock and a suspendedspike from within said packaging structure; non-permanently attachingsaid sterilizing filter, stopcock and suspended spike respectively withsaid syringe; removing a gas pouch from said packaging structure;puncturing a valve on said gas pouch with said suspended spike;withdrawing said plunger from said syringe as necessary to fill saidsyringe with a unit dose of said surgical gas; disconnecting saidsyringe and said sterilizing filter from said stopcock; withdrawing saidplunger from said syringe as necessary to add sterile air to saidsurgical gas; disconnecting said sterilizing filter from said syringe;and capping said syringe with a capped injection needle or cannula. 15.The method of claim 12, 13 or 14 wherein said gas pouch is filled toapproximately atmospheric pressure with a surgical gas.
 16. The methodof claim 12, 13 or 14 wherein said surgical gas is selected from thegroup consisting of sulfur hexafluoride, perfluoropropane,perfluoroethane, nitric oxide, and nitric oxide producing compounds. 17.The method of claim 12, 13 or 14 wherein said gas pouch is manufacturedfrom a laminar sheet formed from three materials of differingcharacteristics.
 18. The method of claim 12, 13 or 14 wherein said gaspouch is manufactured from a laminar sheet of polyester, aluminum andpolyethylene.
 19. The method of claim 12, 13 or 14 wherein said surgicalgas is sulfur hexafluoride, perfluoropropane or perfluoroethane for useas a tamponade in an ophthalmic surgical procedure.
 20. The method ofclaim 12, 13 or 14 wherein said surgical gas is sulfur hexafluoride,perfluoropropane or perfluoroethane for use as a tamponade in anophthalmic surgical procedure to repair retinal tears.